Provider Demographics
NPI:1316472889
Name:ZUNIGA, WYNDEE (COTA)
Entity type:Individual
Prefix:
First Name:WYNDEE
Middle Name:
Last Name:ZUNIGA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1223
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75833
Mailing Address - Country:US
Mailing Address - Phone:979-676-1145
Mailing Address - Fax:
Practice Address - Street 1:2333 MANOR DR
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-1907
Practice Address - Country:US
Practice Address - Phone:979-821-7327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209877224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant